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AF | PDBR | CY2012 | PD-2012-00461
Original file (PD-2012-00461.pdf) Auto-classification: Denied
 
NAME: XXXXXXXXXXXXXXXX                                                               BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1200461                                                                   SEPARATION DATE:  20030411 
BOARD DATE:  20130103  
 
  
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty Soldier, SFC/E‐7(35W/Aviation Avionics Technician), 
medically separated for Crohn’s disease, rated as moderate.  The CI was diagnosed with Crohn’s 
disease in 1997 by a civilian physician prior to entering the military.  Due to persistent diarrhea, 
she was deemed non‐deployable and unable to participate in physical training.  The CI did not 
improve  adequately  with  treatment  to  meet  the  physical  requirements  of  her  Military 
Occupational Specialty (MOS) or satisfy physical fitness standards.  She was issued a permanent 
P3  profile  and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  Crohn’s 
disease as medically unacceptable IAW AR 40‐501.  The MEB forwarded no other conditions for 
Physical  Evaluation  Board  (PEB)  adjudication.    The  PEB  adjudicated  the  Crohn’s  disease  as 
unfitting,  rated  10%,  with  application  of  the  Veteran’s  Affairs  Schedule  for  Rating  Disabilities 
(VASRD). The CI made no appeals, and was medically separated with a 10% disability rating.   
 
 
CI CONTENTION: The CI states: “Crohn’s disease is an uncurable illness, and the small intestine 
resection performed while on active duty has had negative health side effects.  Considering the 
long  term  symptoms  and  their  debilitating  effects  the  service  member  should  have  been 
medically retired.”  
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44 (Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.”  The ratings 
for  unfitting  conditions  will  be  reviewed  in  all  cases.    Any  conditions  or  contention  not 
requested in this application, or otherwise outside the Board’s defined scope of review, remain 
eligible for future consideration by the Army Board for Correction of Military Records. 
 
 
RATING COMPARISON: 
 

VA (5 Mos. Post‐Separation) – All Effective Date 20030412

Service PEB – Dated 20021218 

Condition 

Code 

Crohn’s Disease 

7399‐7323 

↓No Addi(cid:415)onal MEB/PEB Entries↓ 

Rating
10% 

Condition

Crohn’s Disease 
w/Polyarthralgia
Scar Residuals of Ileum 
Resection

Code 
7323 

Rating 
100%* 

7804 

10% 

Exam

20030928 

20030928 
20030928

RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

Combined:  10% 

0% X 3 / Not Service‐Connected x 0 

Combined:  100% 

*Reduced to 30% on 7/1/09, reducing combined to 40%. 
 
 
ANALYSIS SUMMARY:  The Disability Evaluation System (DES) is responsible for maintaining a fit 
and  vital  fighting  force.    While  the  DES  considers  all  of  the  member's  medical  conditions, 
compensation  can  only  be  offered  for  those  medical  conditions  that  cut  short  a  member’s 
career, and then only to the degree of severity present at the time of final disposition.  The DES 

has neither the role nor the authority to compensate members for anticipated future severity 
or  potential  complications  of  conditions  resulting  in  medical  separation  nor  for  conditions 
determined  to  be  service‐connected  by  the  Department  of  Veterans  Affairs  (DVA)  but  not 
determined to be unfitting by the PEB.  However, DVA, operating under a different set of laws 
(Title 38, United States Code), is empowered to compensate all service‐connected conditions 
and  to  periodically  re‐evaluate  said  conditions  for  the  purpose  of  adjusting  the  Veteran’s 
disability rating should the degree of impairment vary over time.  The Board’s role is confined 
to the review of medical records and all evidence at hand to assess the fairness of PEB rating 
determinations, compared to VASRD standards, based on severity at the time of separation.   
 
Crohn’s Disease.  The CI first was diagnosed in the military with Crohn’s disease with bloody 
diarrhea  in  1998,  and  appropriate  treatment  initiated  (Prednisone  and  Mesalamine).    By 
February  2000  the  CI  was  doing  well  with  controlled  symptoms.    A  CT  scan  of  the  abdomen 
obtained 2 May 2000 for increasing abdominal pain revealed active Crohn’s disease in the distal 
small bowel and a large right ovarian cyst of questioned malignant origin.  The CI was scheduled 
for removal of the cyst in December 2001 by the gynecology service.  At a pre‐operative surgical 
clinic visit, the Crohn’s condition was mild with the CI having two to six bowel movements per 
day  without  blood  and  occasional  cramping  abdominal  pain. 
  At  surgery  performed  on 
11  December  2000,  benign  right  and  left  ovarian  cysts,  not  involving  Crohn’s  disease,  and  a 
segment  of  distal  small  bowel  and  attached  proximal  colon,  involving  Crohn’s  disease,  were 
removed.  Post‐operatively the CI did well but manifested continued diarrhea, but with reduced 
abdominal pain.  Colonoscopy performed on 11 July 2001 demonstrated no evidence of residual 
Crohn’s disease at the site of surgery.  At the MEB/narrative summary (NARSUM) evaluation 
performed on 25 November 2002, 4 months before separation, the CI reported 8 to 10 stools 
without blood per day.  The MEB physical exam noted blood pressure, pulse and temperature 
were normal.  Weight was stable with normal body mass index (BMI) of 21.5.  Abdominal exam 
was  normal.    The  remainder  of  the  clinical  exam  was  unremarkable  with  no  evidence  of 
malnutrition.    Blood  testing  revealed  no  evidence  of  anemia.      At  the  VA  Compensation  and 
Pension (C&P) exam on 28 September 2003, 5 months after separation, the CI reported six to 
seven loose stools a day without blood.  She noted mild abdominal tenderness but, her health 
to be good without recent weight loss or malnutrition.  She noted the diarrhea to have a mild 
effect on her functional activity.  On physical examination vital signs were normal and the CI 
noted to be in no distress.  BMI was recorded as 22.7 (normal).  The abdominal examination 
was  unremarkable  and  the  stool  free  of  blood.    The  remainder  of  the  clinical  exam  was 
unrevealing.  Laboratory testing revealed no evidence of anemia.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA both rated the condition under code 7323, colitis, but at different ratings.  The PEB 
rated 10% citing moderate, chronic diarrhea.  The VA rated at 100% citing six to seven loose 
stools  a  day  with  marked  malnutrition,  anemia,  general  disability  and  serious  complications.  
Under this code a 10% rating requires moderate disease, with infrequent exacerbations.  A 30% 
rating  requires  moderately  severe  disease  with  frequent  exacerbations.    The  60%  rating 
requires severe disease, with numerous attacks a year, malnutrition, and health only fair during 
remissions.    The  100%  rating  requires  pronounced  disease,  resulting  in  marked  nutrition, 
anemia, and general disability or with serious complications such as liver abscess.  The Board 
noted the CI to have six to seven stools a day without blood or abdominal pain and to be in 
good general health at the time of separation.  The Board noted the record to document no 
malnutrition,  anemia,  serious  complications,  sepsis  or  flares  of  the  disease  requiring 
hospitalization  or  treatment  with  additional  steroid  medications.    The  Board  unanimously 
agreed the preponderance of evidence supported the condition to be mild to moderate at the 
time  of  separation.    After  due  deliberation,  considering  all  of  the  evidence  and  mindful  of 
VASRD  §4.3  (reasonable  doubt),  the  Board  concluded  that  there  was  insufficient  cause  to 
recommend a change in the PEB adjudication for the Crohn’s condition.   
 

   2                                                           PD1200461 
 

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or 
guidelines relied upon by the PEB will not be considered by the Board to the extent they were 
inconsistent  with  the  VASRD  in  effect  at  the  time  of  the  adjudication.    The  Board  did  not 
surmise  from  the  record  or  PEB  ruling  in  this  case  that  any  prerogatives  outside  the  VASRD 
were  exercised.    In  the  matter  of  the  Crohn’s  condition  and  IAW  VASRD  §4.114,  the  Board 
unanimously recommends no change in the PEB adjudication.  There were no other conditions 
within the Board’s scope of review for consideration.   
 
 
RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows:   
 

VASRD CODE  RATING
7399‐7323 
COMBINED 

10%
10%

Crohn’s Disease 

UNFITTING CONDITION

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120531, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
SFMR‐RB 
 

 
 

 

 

 

           XXXXXXXXXXXXXXXX, DAF 
           President 
           Physical Disability Board of Review 

 
 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency  

(TAPD‐ZB / XXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202‐3557 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 

XXXXXXXXXXXXXXX, AR20130000812 (PD201200461) 

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD 
PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under 

the authority of Title 10, United States Code, section 1554a,   I accept the Board’s 

recommendation and hereby deny the individual’s application.   

This decision is final.  The individual concerned, counsel (if any), and any Members of Congress 

who have shown interest in this application have been notified of this decision by mail. 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 
 

 

 
 

 

 
 
 

   3                                                           PD1200461 
 

 

 

 
 
 
  
 . 
 
 
  
  
  
       
  
      ‐   
                          

Encl 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards) 

 

 

 

 

 
CF:  

(  ) DoD PDBR 

(  ) DVA 

 

‐ 

 

   4                                                           PD1200461 
 



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